Schizophrenia Speech Patterns And Other Symptoms

Schizophrenia can cause a variety of symptoms. You may already be familiar with some, like hallucinations and delusions. However, you might not know that schizophrenia can also affect the ways people speak. They might display “word salad,” poverty of speech, echolalia, derailment, and more. Disorganized speech and other schizophrenia symptoms can often be managed with the proper support and treatment.

Schizophrenia: An overview

Schizophrenia is often a severe mental illness. Usually starting in the young adult years, this disorder can change the ways people experience reality, express emotions, and interact with others. Scientists still haven’t determined the exact cause of schizophrenia. However, certain factors may raise people’s risk, such as genetics, birth weight, and childhood environment. 

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a guide that can help doctors diagnose mental health disorders. The manual generally lays out definitions and criteria for a variety of mental illnesses. In the latest version of the DSM (DSM-5), schizophrenia is listed as a “psychotic disorder." Psychotic disorders can be defined as mental illnesses that involve losing track of reality or having a “psychotic episode.” People with schizophrenia may experience multiple psychotic episodes during their lives. 

Symptoms of schizophrenia

Schizophrenia can cause a variety of symptoms affecting people’s thoughts and behavior. These symptoms may be more intense during psychotic episodes, but they may also continue when a person is no longer in psychosis. Some examples include the following:

• Hallucinations: When you hallucinate, you may see, hear, or feel something that isn’t there. People with schizophrenia may commonly hear voices or other sounds. They may also have visual hallucinations, although this tends to be rarer. 
• Delusions: A delusion is usually a false belief that a person holds strongly, despite evidence against it. Schizophrenia can involve various types of delusions. For example, a person might believe they can read minds, that the government is spying on them, or that their TV is sending them hidden messages. 
• Changes in mood and motivation: Schizophrenia can make it hard to experience pleasure. The condition can also affect motivation to do daily tasks. As a result, people with schizophrenia may stop bathing, going to work, seeing their loved ones, or engaging in hobbies.  
• Changes in emotional expression: Schizophrenia can also make people less expressive. For example, someone might stop showing facial expressions or using gestures to communicate. People with schizophrenia may also talk in a flat tone of voice. 
• Disorganized speech: “Disorganized speech” generally refers to abnormalities in a person’s way of thinking that come across in the way they speak. Because thoughts and speech tend to be intertwined, this symptom is sometimes also called “formal thought disorder.”

These symptoms and others can create challenges for people with schizophrenia. They may have trouble at work, in relationships, and in daily life. They may also experience other mental illnesses, like anxiety and depression. 

Exploring common schizophrenia speech patterns

Now that we’ve considered general schizophrenia symptoms, let’s focus on one: disorganized speech. Language abnormalities can be common among people with schizophrenia, but what do they look like? The answer to this question may not be the same for everyone. However, there are a few common forms of disorganized speech. 

Word salad

“Word salad” can describe a way of speaking that is incomprehensible to other people. For example, a person might string random words together, speak in sentence fragments, or change the order of words to the point where other people can’t follow what they’re saying. 

Poverty of speech

“Poverty of speech” usually refers to speaking very little. For example, someone might only respond to questions with one-word answers. They might also refuse to talk without being prompted by others.

Making up new words

People with schizophrenia may come up with new words and phrases. This can make it hard for others to follow what they’re saying. For example, a person might say something like, “I took my ‘spuzzle’ out to the ‘skove’ this morning.”

Echoing other people

When a person with schizophrenia is talking to someone else, they might repeat what the other person says rather than responding to it in their own words. This symptom can also be called “echolalia.”

Going off on tangents

Also known as “derailment,” this can happen when someone loses track of their original point as they speak. They might bounce between ideas or follow a train of thought that’s hard to understand. For example, someone might say, “Today I had ice cream, which was cold. Winter is almost here. That reminds me, I need to get a winter coat. Maybe a green one. I like looking at the green grass. It’s green like spinach. I know I need to eat healthier.”

Scientists are looking into the neurological reasons or “neural correlates” for these language disturbances within the brain. In a study from 2017, 51 schizophrenia patients were interviewed to analyze their speech. They were also given tasks to analyze various brain functions. Researchers found that communication problems were often associated with the following:

• Poor working memory 
• Poor performance on cognitive tasks
• Low information processing speed

Given this, there might not be one specific factor that causes schizophrenia-related speech changes. Rather, it may be that schizophrenia causes general issues with cognitive function that may lead to speech disorders. That said, this topic is still being researched.

Getting treatment for schizophrenia

Living with schizophrenia can be challenging. However, various treatments may support your mental health and improve your daily functioning. Some examples can include medication, social skills training, and community support programs. 

Other treatments are being explored for schizophrenia-related speech disorders. In 2016, researchers gave 17 patients with schizophrenia a specialized communication program. After 20 sessions, participants typically saw a significant improvement in their communication, language skills, and social appropriateness. 

Psychotherapy may be helpful if you have schizophrenia. By working with a therapist, you may be able to improve your thought patterns and develop healthy ways of managing your symptoms. If you’re living with other mental health conditions besides schizophrenia, a therapist may be able to help you reduce those symptoms as well. 

Start the journey to reducing schizophrenia symptoms

Get matched with a mental health professional

Adhering to your treatment plan may ease the challenges of living with schizophrenia—and that may be easier to do if you have a therapist you trust. That said, finding the right mental health professional can sometimes take trial and error. Online therapy platforms like BetterHelp typically let you change therapists at any time, at no additional cost. This may make it easier to find the right therapist for you. 

A growing body of research shows that online therapy can effectively treat anxiety and depression, which can often occur alongside schizophrenia. In 2017, researchers analyzed data from 373 studies of internet-based therapy. They found that online therapy was usually effective at treating depression, anxiety, PTSD, bipolar disorder, and more. However, in-person support may be needed if you’re experiencing acute psychosis.